Bleeding During Veno-Venous ECMO: Prevention and Treatment

Johannes Kalbhenn; Barbara Zieger

doi:10.3389/fmed.2022.879579

Bleeding During Veno-Venous ECMO: Prevention and Treatment

Front Med (Lausanne). 2022 May 23:9:879579. doi: 10.3389/fmed.2022.879579. eCollection 2022.

Authors

Johannes Kalbhenn¹, Barbara Zieger²

Affiliations

¹ Department of Anesthesiology and Critical Care, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany.
² Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany.

Abstract

Veno-venous extracorporeal membrane oxygenation (vvECMO) has become a routine treatment for severe lung failure in specialized centers. Spontaneous bleeding complications, however, are observed in 30-60% of patients during vvECMO treatment. Bleeding increases mortality by factors 2-3. Anticoagulation in combination with several acquired bleeding disorders caused by the mechanical pump and the foreign layer of the extracorporeal system contribute to the risk of bleeding. In this review, the mechanisms of the underlying pathologies and the route from diagnosis to treatment are described.

Keywords: ARDS; ECMO; acquired von Willebrand syndrome; bleeding; prevention; thrombosis; treatment.

Publication types

Review